Gross motor delay and global developmental delay

Tummy time baby physiotherapy assessment

What is gross motor delay?
Babies learn so many skills in their first stages of life. These will be assessed during check-ups from your health visitor and will focus on three main areas: cognitive and social skills (the mind), gross motor skills (large physical movements) and fine motor skills (more complex, smaller movements with the arms). There is a large spectrum of typical developing skills in all three areas, and your baby’s skills will be compared to the normative data. Sometimes, one or more of these areas can be delayed, or behind in comparison to babies the same age. When the gross motor skills only are delayed, this may be referred to as gross motor delay, or GMD. It is not a diagnosis in itself, and can be a symptom of another condition. Commonly, GMD also occurs for no other reason, and babies frequently catch up on their skills. Signs of GMD include not reaching gross motor milestones within the typical time frames, such as sitting, rolling and crawling.

What is global developmental delay?
Global developmental delay (GDD) is when all three of the developmental aspects are delayed; cognitive and social, gross motor skills and fine motor skills. This is usually a result of an underlying condition, and tests should be arranged by a paediatrician to detect any abnormalities. Signs of GDD include not reaching milestones from all developmental areas, within the typical time frames. For example, eye contact and smiling, babbling, rolling and sitting, playing with toys and picking up objects. Usually, a health visitor will refer your baby to other professionals to assess the different areas. A physiotherapist will have a look at gross motor skills, an occupational therapist will assess fine motor skills, and cognitive or speech development can be considered by a specialist paediatrician or speech and language therapist.

Postural assessment in baby physio session

Children’s physiotherapy will always assess gross motor skills, even with GDD, as this is where their skill set lies. They will work closely with other professionals in cases of GDD, to incorporate different skills into sessions.

Positional activities in baby physiotherapy assessment

Physical symptoms
GDD and GMD are characterised by slow developing gross motor milestones. For example, a tiny baby may struggle with head control on their front, and may not tolerate tummy time. An older infant may not be able to sit or crawl yet, or a toddler-aged child may not walk independently. Sometimes these issues can be due to a lack of confidence alone, other times it is due to another condition causing the symptoms. Babies with GMD or GDD may become frustrated if they can’t get to a toy or their parents through mobilising. It is difficult to know the cause of the delays, until a diagnosis is found (if there is one).

Functional baby physiotherapy

Our superheroes
Our superbabies with gross motor delay love nursery rhymes and being read to! We are experts in distraction  and use all sorts of techniques to take babies’ mind off the task in hand! Eighteen-month-old Temi came to us for six months when her mother noticed she was not motivated. Temi was diagnosed with GMD aged 12 months, and improved all her motor skills, reaching her milestones on time in her time with BBP! Other superheroes have been given diagnoses and we have been able to educate and advise parents from their baby’s early age, to give them the best outcome. Eighteen-month-old Harley came to BBP with GMD in 2018, and was diagnosed with cerebral palsy as a result of HIE. Team BBP were able to supply a standing frame and work on improving hip development at a very young age, significantly improving her leg strength.

How can physiotherapy help?
Physiotherapy for GDD and GMD focusses on improving and developing gross motor skills through play, function and daily activities.

Gross motor skills
We provide fun programmes for our gross motor superbabies! We demonstrate all our techniques to parents and carers and recommend times and frequencies. Your tailored programme will include beautiful illustrations and detailed instructions, and videos of our exercises are also available on YouTube! Some babies work best with exercises carried out little and often by parents, throughout the day. Other babies work better in a set time limit with a physiotherapist, and prefer having cuddles with parents, leaving the exercises to the physiotherapist! Whatever you and your family chooses, we do not over- recommend sessions and fully support the needs of your baby. Your baby will be set six-week gross motor goals, and these may be reviewed over email or in person, to determine the best steps to take from there.

Sometimes different positions will be recommended for daily activities. For example, supported standing while reading a book, side lying while playing, or tummy time when reaching toys. All of these positions utilise factors such as gravity, muscle positions for activation, and facilitation of movement. They will be demonstrated and included when necessary in your baby’s programme.

Education and advice
Being a new parent is overwhelming, with lots to learn. We are here to help and guide you with your baby’s physical skills, and can advise on the best baby pushchairs, slings, bouncers and walkers. We will tailor our advice to your baby’s and family’s needs.

Baby neurodevelopmental physiotherapy programme

Often, it is recommended to get advice or assessments from other professionals. Sometimes our physio team will pick up on other skills, like a poor head position leading to difficulty swallowing, or social skill issues such as reduced eye contact. We know the best paediatricians and therapists to refer to, and we also work closely with NHS professionals. We are able to write to your GP to urgently refer to other services when required. We may also recommend other special needs equipment or orthotics to help your baby reach their full physical potential. We keep stock items of commonly used equipment to loan to families, free of charge.

Function and participation
All of our short- and long-term goals are geared towards function, or play, in babies’ eyes! Every skill learned in physiotherapy sessions is aimed towards a functional task involving toys, socialising or movement towards toys or parents!

Have a look at our very own superhero Atlas, to see what fun he has in physio!

Find out how we can help your superbaby reach their full potential by getting in touch with us!